RESULTS: Of the 268 patients reviewed, 135 were excluded (47 did not meet criteria for septic shock, 88 had significant heart disease, and 15 had missing data). Of the included patients, 61% were female, 29% were non-white, mean age was 67 years. Ultimately, 117 septic shock patients were included in this analysis and 57 died in hospital. Mean lactate level was 4.24 mmol/L (SD 3.63), and lactate clearance of at least 10% from baseline was observed in 45/63 cases (71%). As expected, baseline lactate levels were a strong predictor of mortality - an increase of 1 mmol/L was associated with a 15% increased risk of death (HR 1.15, 95% CI 1.07-1.23, p<0.001). Additionally, in patients with septic shock complicated by ARDS, lactate clearance of at least 10% from baseline was associated with a reduced mortality risk of 97% (HR=0.03, 95% CI 0.002-0.44, p=0.01).